Why medical cannabis is not prescribed for bipolar disorder
5 min read
Lucy MacKinnon
Now that medical cannabis has been legally available in the UK for almost six years, powerful patient testimonials are hitting the press highlighting how medical cannabis has helped people manage PTSD, depression, and anxiety symptoms.
This, in turn, has led many to wonder what other conditions can or can’t be treated with medical cannabis in the UK, and, one condition that’s often queried is bipolar disorder.
While there is evidence that suggests medical cannabis can make a useful addition to some mental health treatment plans because of its mood-uplifting qualities, there is a lack of sufficient evidence that proves medicines derived from cannabis are safe and effective for individuals with bipolar disorder.
Therefore, private clinics in the UK like Releaf do not routinely prescribe medical cannabis to patients who have been diagnosed with bipolar disorder. Dr Vijay Delaffon, an expert in psychiatry and one of Releaf’s specalist doctors, explains:
"At Releaf, we generally do not prescribe cannabis-based treatments to patients who have been diagnosed with certain complex mental health conditions, and this includes bipolar disorder. This is because there is inconclusive evidence to support the use of medical cannabis in bipolar disorder treatment plans, and there are significant risks associated with the use of cannabis in individuals who have bipolar disorder. As healthcare providers, it’s imperative we act responsibly and put patient safety first.
However, we are happy to take a case by case approach – for examples where patients have been stable for extended periods and have support from family and medical professionals etcetera."
Contents
What is bipolar disorder?
While everyone encounters changes and fluctuations with their mood, bipolar disorder intensifies emotions and causes people to feel extreme highs and lows for extended periods of time.
This can come in the form of mania, causing impulsive behaviours, excitement, agitation and increased energy, or in the form of extreme depression where a person feels severely low and may struggle with low-self esteem, a lack of energy, and, often, suicidal thoughts.
The stark differences between these emotional states, and the unpredictability of their occurrence, can make bipolar disorder overwhelming and distressing to live with - and so, it's important those with bipolar disorder are able to find an effective treatment option that works for them.
While the true cause is still unknown, genetics are thought to be the root factor in around 9% of bipolar disorder cases. This is because almost 1 in 10 people with bipolar disorder have a close family member who also lives with the condition, but environmental factors, such as experiencing traumatic or stressful events, are also believed to contribute to the development of bipolar disorder.
And, how is bipolar disorder treated in the UK?
In the UK, the NHS typically recommend a combination of talking therapies and medication when treating people with bipolar disorder. This often involves courses of cognitive behavioural therapy or interpersonal therapy, which are designed to help people understand their condition and find the right way to navigate their symptoms for them, as an individual.
The medications prescribed to people with bipolar disorder tend to fluctuate depending on the symptoms they feel at present.
When a person is in a period of mania or hypomania, antipsychotics are often recommended. This includes drugs like Risperidone, Quetiapine, Haloperidol, and Olanzapine. Alternatively, if a person is experiencing a depressive episode, they’re usually prescribed antidepressants like Lithium, Fluoxetine, Sodium Valproate or Lamotrigine.
How does cannabis affect the symptoms of bipolar disorder?
The cannabis plant contains a myriad of different natural chemicals, some of which have been linked to having therapeutic or beneficial effects on a number of health conditions and their symptoms.
While on a surface level it is not uncommon to assume CBD may be able to alleviate some of the symptoms associated with bipolar disorder, by promoting a sense of calm or relaxation and uplifting mood, cannabis use is not recommended for individuals with bipolar disorder because of the inclusion of CBD’s chemical counterpart: THC.
THC, or tetrahydrocannabinol, has been linked with problematic effects for individuals with bipolar disorder. This includes triggering episodes of mania or psychosis, where anxiety reaches extreme peaks, sometimes on setting paranoia, or even on occasion, cognitive impairment.
There is also a high correlation between patients with bipolar disorder and issues with substance abuse, and so this is another potential risk factor depending on the individual.
Is it safe to take medical cannabis if you have bipolar?
Because of this risk factors stated above, it is not typically advised to use cannabis if you have bipolar disorder, and in the UK, medical cannabis clinics are unlikley to prescribe cannabis-based therapies for treating this condition.
Can you get medical cannabis for bipolar disorder in the UK?
At Releaf, we do not routinely issue prescriptions for medical cannabis to patients who have a history or diagnosis of bipolar disorder because there is insufficient evidence to justify its application in these areas, and significant risk potentials.
This is also the case for patients who have been diagnosed with schizophrenia or schizoaffective disorder for similar reasoning. We previously discussed this on our blog with Graham Woodward, our Chief Medical Officer and a former NHS psychiatric nurse who has over 28 years of experience working in healthcare.
Graham Woodward explained:
“Although medical cannabis has been shown to benefit other mental health symptoms such as anxiety and depression, the current evidence available does not support its application in patients with schizophrenia due to the numerous risks involved.
“Our primary responsibility is to keep patients safe and improve their health outcomes. Therefore, until more conclusive evidence is available, we must err on the side of caution and prioritise proven safe and effective treatments for this vulnerable population."
And the same is true in the case of bipolar disorder.
How to access bipolar support
If you or a loved one are living with bipolar disorder and you are looking for support services or a new treatment option, you may find the websites listed below helpful.
Hub of Hope: This UK-wide service database can help you find local or national peer community groups, charities, and private and NHS mental health support services close to you in a number of minutes. Simply visit: hubofhope.co.uk
Mind: Mind is a mental health charity based in England and Wales that offers advice, information, and education on mental health conditions and their impact on day-to-day life here in the UK. Visit Mind here: mind.org.uk
Bipolar UK: For support specific to bipolar disorder, Bipolar UK offer guidance and information on how to effectively manage symptoms like hypomania and mania through peer support by creating local support groups, online communities, and through their telephone support line. You can access their website by visiting: bipolaruk.org
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It is important to seek medical advice before starting any new treatments. The patient advisors at Releaf are available to provide expert advice and support. Alternatively, click here to book a consultation with one of our specialist doctors.
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With five years of journalism and healthcare content creation under her belt, Lucy strives to improve medical cannabis awareness and access in the UK by producing high quality, credible content.
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